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Iraqi university students protesting against the government, 2020. Credit: Mohsin/Shutterstock

By Shivan Fazil and Alaa Tartir
STOCKHOLM, Sweden, Mar 24 2023 (IPS)

Over the past two decades Iraq has been affected by several waves of intense conflict and violence. The 2003 invasion of Iraq by a multinational coalition led by the United States and United Kingdom toppled the Ba’athist regime of Saddam Hussein.

It also ushered in years of chaos and civil war, as a variety of armed groups vied for power and territory and targeted coalition forces and the fledgling post-Ba’athist Iraqi Army.

A period of relative calm in the early 2010s was broken by the rise of the extremist Islamic State group, which occupied large parts of the country from 2014 until it was largely defeated by Iraqi forces with the support of a US-led international coalition in 2017.

Today Iraq is enjoying its most stable period since 2003. Armed violence persists in different forms, but it is sporadic, fragmented and localized. However, the country remains fragile and divided, and its people face an array of deepening challenges that the state is struggling to address. This Topical Backgrounder aims to provide a snapshot of the situation in Iraq 20 years since the invasion.

A fragile, oil-dependent economy

Crude oil exports accounted for an estimated 95 per cent of federal revenues in 2020. Successive governments have done little to wean Iraq off this heavy dependency on oil rents and diversify the economy. This has led to a bloated public sector characterized by patronage and to a shortage of jobs for new graduates—especially those without the necessary connections and networks.

The dependency on oil rents also exposes the Iraqi economy to fluctuations in global oil prices. Not only does this make long-term development planning difficult, but in 2020, when global oil prices plunged, the government was left unable to fund basic services or even pay public-sector salaries and pensions.

Public debt reached 84 per cent of gross domestic product (GDP), and GDP itself fell 16 per cent, inflaming anger at the government. Although oil prices quickly recovered, two years of government paralysis and political turmoil have made it difficult for Iraq to take advantage and invest the increased revenues.

Despite having large natural gas reserves, Iraq currently relies on gas imports from Iran. The US and Iraq’s European partners are keen to end this dependency and to help Iraq become energy-independent.

However, the political and economic turmoil of the past few years in Iraq have stalled investment in capacity to separate and process gas from Iraqi oil fields, and instead vast quantities of gas associated with oil extraction are flared off.

This leaves Iraq still dependent on Iranian gas and electricity imports, greatly increases its climate footprint and creates acute air pollution in parts of the country. The situation is a prime illustration of the complexity of Iraq’s security challenges and governance failures, which interact in complex ways with its oil-dependent economy, tumultuous regional dynamics and environmental issues.

The changing face of armed violence

Today, Islamic State is thought to be unable to recruit more members in Iraq and only an estimated 500 fighters are still active in the country. Major military operations against Islamic State have thus ended.

In 2020, the US began reducing its military footprint in Iraq—which had risen sharply in response to the rise of Islamic State—and only around 2500 US military personnel remain in the country, at Iraq’s invitation, in an advisory role.

A key task as the threat from Islamic State dissipates is to deal with the Popular Mobilization Forces (an Iraqi state-sponsored umbrella organization comprising a number of predominantly Shia militias, some supported by Iran) as well as smaller militia groups linked to ethno-religious minorities in the country’s north that were formed in the name of community self-defence.

One of the goals of successive Iraqi governments has been integrating these forces into the Iraqi security forces, but progress has been slow. Most of the militias are nominally under the Ministry of Defence.

However, many seem to act independently of government and outside institutional jurisdiction. Some have been accused of human rights violations and abuses against civilians, particularly during the mass anti-government protests in 2019.

Another task, being urged by the US and the anti-Islamic State coalition, is to improve how the Peshmerga—the armed forces of the Kurdistan Region of Iraq (KRI)—and the Iraqi Armed Forces interact.

A lack of coordination and intelligence-sharing has undermined the efficiency of security operations, particularly in the disputed territories of Iraq. Prior to the emergence of Islamic State in 2014, the Kurdistan Regional Government (KRG) and the federal government in Baghdad were jointly administering security in these territories.

Iraq has also suffered from the spillover of civil conflicts and counterinsurgency in neighbouring countries, especially in some of its more remote regions. Iran and Türkiye have both launched missile strikes or armed incursions against opposition forces on Iraqi territory in recent years.

Identity politics and worsening state-society relations

The United States and other members of the coalition that invaded Iraq in 2003 and supported its transition to post-Ba’athist democracy lacked a long-term vision. They often failed to anticipate the consequences of major decisions, such as the disbanding of the Iraqi Army in 2003 or several initiatives put forward by the transitional authorities.

One of the most consequential of these initiatives was the establishment of Muhasasa Ta’ifia, a form of consociationalist elite bargain that was adopted after 2005. Under Muhasasa Ta’ifia, government posts, sinecures and departments are shared out among the Kurdish, Shia and Sunni political elites after an election—often after a lot of fraught inter-factional horse-trading.

Voters are offered a choice of parties within a given ethnosectarian bloc, but no choice of policy platforms. There is no parliamentary opposition to hold the government accountable.

Muhasasa Ta’ifia was conceived as a way to stop Iraq fracturing and divisions along the major ethnosectarian faultlines, to encourage the groups to collaborate and to avoid one group becoming too dominant. While it has arguably succeeded to an extent in those aims, it has also given rise to ineffective governments, lack of accountability, and a public sector rife with corruption and patronage.

As a result, a major new faultline has emerged, with ordinary citizens united across ethnosectarian lines by grievances against the governing class. Along with corruption, citizens complain of economic mismanagement, unemployment, crumbling infrastructure, weak public services and more. Largely youth-led anti-government protests in 2019 expressed their feelings of alienation from the political elite with the slogan ‘We want a homeland’.

Mass protest has been growing since 2015. The October Protest or Tishreen Movement that began in 2019 was large enough to topple the government of Prime Minister Adil Abdul-Mahdi in early 2020 and was violently suppressed by state forces and militias.

Muhasasa Ta’ifia caused another political crisis in 2021–22 when elites were unable to agree on a new government for over a year after a general election in October 2021. Voter turnout in that election fell to a record low of 44 per cent, illustrating the growing popular disillusionment and frustration with the political system.

Muhasasa Ta’ifia seems unlikely to change in the near term, but there are some signs that it is slowly breaking down, and perhaps even starting to make way for a more issue-based politics. For example, political factions have recently been forming alliances beyond their ethno-sectarian blocs.

Following the 2021 election, Muqtada al-Sadr, the leader of the Shia Sadrist movement, proposed forming a majority government with a sizeable parliamentary opposition—although this was rejected by other factions.

More positively, the Tishreen Movement spawned its own political candidates, some of whom won seats. Their potential to influence federal politics is negligible, but they may be able to push forward change in subnational politics.

The Kurdistan Region in federal Iraq

The Kurdistan Regional Government has a peaceful, if occasionally fraught, relationship with the federal government in Baghdad. The KRG enjoys a high level of autonomy, which includes maintaining its own military forces, the Peshmerga.

Early on in the transition process after 2003, Kurdistan was recognized as Iraq’s most stable region, and its leaders as having valuable experience of government that the other transitional authorities lacked. This was also partly due to the no-fly zone and other measures to protect the Iraqi Kurds from Iraqi government attacks implemented by the United States and European partners after the first Gulf War in 1991.

The Kurds in Iraq have largely distanced themselves from the Kurdish independence movements in neighbouring Iran, Syria and Turkey, to the extent that Peshmerga forces have even clashed with Turkey’s Kurdish Workers’ Party (PKK) forces operating on Iraqi soil.

Relations between the KRG and the federal government are complicated by long-standing disagreements over oil revenue sharing and control of the disputed territories, which include the oil-rich city of Kirkuk. The KRG brought these territories under its control after Iraqi security forces withdrew in the face of Islamic State advances in 2014. Resolving the status of the disputed territories should have taken place a decade earlier, according to the 2005 constitution.

When the major military operations to defeat Islamic State came to an end in 2017, tensions between the federal government and the KRG were intensified by the KRG’s push for greater autonomy. The KRG organized a referendum for independence that also included the disputed territories that were then under its control (including Kirkuk).

The federal government rejected the referendum and retook the disputed territories with military force, supported by the Popular Mobilization Forces, and implemented other punitive measures against the KRG.

The KRG and state-society relations in the KRI have similar problems to those found at the federal level. The KRG budget relies heavily on independent oil exports and on budget transfers from Baghdad, removing the incentive to diversify the economy. And the two main Kurdish factions, the Kurdistan Democratic Party and the Patriotic Union of Kurdistan, have been in a power-sharing agreement since the unification of two Iraqi Kurdish enclaves in 2006.

This agreement sees government and administrative posts shared between the two parties—an arrangement not dissimilar to Iraq’s Muhasasa Ta’ifia. As in the rest of Iraq, residents of the KRI complain of corruption, patronage and mismanagement by the Kurdish authorities. Many have left Iraq to seek asylum in Europe and elsewhere.

Relations with Iran and the US

In the field of diplomacy, Iraq’s strongest relationships and ties are with Iran and the US. Nevertheless, Iraq has sought to diversify its diplomatic and economic relations in recent years, including with Arab Gulf states as well as Egypt and Jordan.

Iran is Iraq’s largest trading partner, although Iraq’s imports from Iran—worth around $9 billion in 2018—vastly outweigh trade in the other direction. Iraq and Iran have also cooperated extensively in the fight against Islamic State.

Iran’s influence in Iraq, much of it exercised through Shia political factions, has been a source of anger among protesters, especially as Iranian-backed militia groups have been involved in violence against anti-government protests.

In addition to having guided the post-invasion political transition, the USA remains Iraq’s main source of security support and of military and development aid. The USA has recently increased pressure on Iraq for tighter control of dollar sales in order to stamp out potential money laundering that benefits Iran and Syria.

Steps taken to do this contributed to a significant drop in the dollar value of the Iraqi dinar, leading to soaring inflation in early 2023 and the replacement of the central bank governor.

Iraq has been caught in the middle of regional tensions, particularly due to its diplomatic and geographic closeness to Iran. In recent years Iraq has tried to take an active role in resolving these tensions. For example, with French support Iraq has organized two regional summits—one in Baghdad the other in Amman, Jordan—aimed at de-escalating regional tensions. In 2021 Iraq hosted talks between Iran and Saudi Arabia, a prelude to the China-brokered détente announced in March 2023.

The situation for Iraq’s minorities

State failure to protect Iraq’s many ethno-religious minorities is a long-standing problem. Since 2003, many minorities have been displaced due to insecurity, often migrating to the KRI—which was seen as calmer, safer and more tolerant—and in many cases out of Iraq altogether.

The Islamic State group targeted minorities, particularly those of non-Abrahamic faiths. The worst of this was in Nineveh Province, known for its mosaic of ethnic and religious diversity. The Islamic State attacks on the Yezidi group in Sinjar district were so devastating that they have been recognized as a genocide.

Many of the minorities who were displaced during the Islamic State occupation have not returned—partly down to the presence of the many militias still active in their areas of origin and a general sense of insecurity, but also because they feel they can make a better life in their new homes.

A UN-brokered agreement between the KRG and the federal government in 2021 that was aimed at normalizing the security situation in Sinjar has had little effect on the ground that would encourage the internally displaced Yezidis to return.

Although minority citizens in Iraq are experiencing lower levels of armed violence based on their identity, discrimination against them seems to have worsened in the wake of the Islamic State occupation. SIPRI has been working in the Nineveh Plains region on ways to improve intercommunal relations and help minorities to re-establish their cultural practices and social relations.

Multiple civil society and grassroots groups are pushing for a reimagining of Iraq, where ethnicity and sect play a much smaller role. However, Iraq’s powerful political blocs are keen to maintain the current power-sharing arrangement, even though it does not seem likely to bring prosperity or lasting peace.

The legacy of the invasion still runs through many of the challenges that Iraq faces, but no longer defines them. Gradually, Iraq is shaping its own destiny—hopefully to the benefit of all its citizens.

Read more about SIPRI’s package of interviews, opinion pieces and reference materials to mark the 20th anniversary of the invasion of Iraq.

Shivan Fazil is a Researcher with the Middle East and North Africa Programme at the Stockholm International Peace Research Institute (SIPRI). Dr Alaa Tartir is a Senior Researcher and Director of SIPRI’s Middle East and North Africa Programme.

IPS UN Bureau

 

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On Mar. 22, 2023, dozens of people watched a live broadcast from San José, Costa Rica, on a large screen at the University of El Salvador, in San Salvador, of the open hearing of the Inter-American Court of Human Rights, listening to the testimony of witnesses in the Beatriz v. El Salvador case. The screenshot shows Beatriz's mother giving her testimony. CREDIT: Edgardo Ayala/IPS

By Edgardo Ayala
SAN SALVADOR , Mar 24 2023 (IPS)

An open hearing in the Inter-American Court of Human Rights in the Beatriz v. El Salvador case is raising hopes that this country and other Latin American nations might overturn or at least mitigate the severe laws that criminalize abortion.

That will happen if the Inter-American Court rules that El Salvador violated the right to health of Beatriz, as the plaintiff is known. In 2013 she sought to have her pregnancy terminated because it was high risk and her life was in danger."I hope that in the end my daughter's name will be vindicated, and that what happened to her will not happen again to any other woman.” -- Beatriz´s mother

But she was not given an abortion, only a tardy cesarean section, which affected her already deteriorated health and, according to the plaintiffs, eventually led to her death in October 2017.

The hearing on the emblematic case was held Mar. 22-23 at the Inter-American Court in San José, Costa Rica. Beatriz’s case builds on similar ones: the cases of Amelia, also from El Salvador, Esperanza from the Dominican Republic, and Amelia from Nicaragua.

The seven judges heard the arguments of the plaintiffs, the representatives of the Salvadoran State and the witnesses on both sides.

After the hearing, the parties have 30 days to deliver their written arguments and the magistrates will then take several months to debate and reach a resolution.

 

The open hearing held by the Inter-American Court of Human Rights on the Beatriz v. El Salvador case is the first time that the complete ban on abortion has been tried, and the verdict will have implications for Latin America, a region that is especially restrictive in terms of women’s sexual and reproductive rights. CREDIT: Inter-American Court of Human Rights

 

A historic case

“I hope that in the end my daughter’s name will be vindicated, and that what happened to her will not happen again to any other woman,” Beatriz’s mother said when testifying on the stand. Her name was not revealed in court.

The hearing has drawn international attention because it is considered historic for the sexual and reproductive rights of women in a region that is especially restrictive with regard to the practice of abortion.

“This will be the first case where the Court will rule on the absolute prohibition of the voluntary interruption of pregnancy, particularly regarding the risk to health and when the fetus is nonviable,” Julissa Mantilla Falcón, from the Inter-American Commission on Human Rights (IACHR), told the Inter-American Court.

Beatriz turned to the IACHR when the Constitutional Court of El Salvador denied, on Apr. 11, 2013, her request for an abortion.

On Apr. 19, the IACHR issued a precautionary measure in favor of Beatriz, and on May 27, 2013, it asked the Inter-American Court to adopt provisional measures which would be binding on the State.

In its November 2020 Merits Report, the IACHR established that the Salvadoran State was responsible for the disproportionate impact on various rights of Beatriz, by failing to provide her with timely medical treatment due to the laws that criminalize abortion.

The IACHR identified the disproportionate impact of this legislation on Salvadoran women and girls, especially the poor.

The Commission stated that it did not expect full compliance by the State with the recommendations of the report, and therefore referred the case to the Inter-American Court, which now, ten years later, is a few months away from handing down a resolution.

 

Anabel Recinos, from the Citizen Association for the Decriminalization of Abortion, one of the Salvadoran organizations that are co-plaintiffs in the Beatriz v. El Salvador case, hopes that the Inter-American Court sentence will set a legal precedent and pave the way for the modification of the 1998 law criminalizing abortion under any circumstances in El Salvador. CREDIT: Edgardo Ayala/IPS

 

For her part, Anabel Recinos, from the Citizen Association for the Decriminalization of Abortion, one of the Salvadoran organizations that are co-plaintiffs in the case, told IPS that she hopes that the Inter-American Court ruling will set a new precedent.

She said her hope is that the court will rule that laws in El Salvador and the region banning abortion under all circumstances must be modified.

In addition to El Salvador, Honduras, Nicaragua and the Dominican Republic are the countries in the region where abortion is completely prohibited in their penal codes. It is only legal in five countries in Latin America, while it is allowed only in strict circumstances in the rest.

“Or at least it should be allowed for specific reasons or exceptions, such as safeguarding health and life, or the incompatibility of the fetus’s life outside the womb,” Recinos said.

Twenty Latin American and Caribbean countries recognize the jurisdiction of the Inter-American Court: Argentina, Barbados, Bolivia, Brazil, Chile, Colombia, Costa Rica, Dominican Republic, Ecuador, El Salvador, Guatemala, Haiti, Honduras, Mexico, Nicaragua, Panama, Paraguay, Peru, Suriname and Uruguay.

The IACHR and the Court make up the inter-American human rights system. They are independent bodies and in the case of the Court the sentences are final and binding, although they are not always enforced.

Recinos spoke to IPS at the University of El Salvador, in the country’s capital, where dozens of people gathered to watch the hearing, broadcast live from San José, on a large screen.

The activist added that it is likely that the Court will rule against the Salvadoran State, backing the IACHR’s conclusions.

The Court is made up of judges Ricardo Pérez Manrique (Uruguay), Humberto Sierra Porto (Colombia), Eduardo Ferrer Mac-Gregor (Mexico), Rodrigo Mudrovitsch (Brazil), Nancy Hernández López (Colombia) and Verónica Gómez (Argentina).

In March 2003, Beatriz requested an abortion during her second pregnancy, because she suffered from lupus, an autoimmune disease in which the body’s immune system mistakenly attacks healthy organs, and preeclampsia, a dangerous increase in blood pressure during pregnancy, as well as other health problems.

In other words, her life was at risk. In addition, the fetus had malformations and would not live long at birth.

However, the medical personnel, although they were aware that an abortion was indicated to save Beatriz’s life, did not carry it out due to the fear of prosecution.

Beatriz was forced to continue with a pregnancy that continued to harm her health as the days went by.

But after the Inter-American Court granted provisional measures, Beatriz underwent a cesarean section on Jun. 3, 2013, almost three months after requesting an abortion.

The child, who was born with anencephaly, missing parts of the brain and skull, died just five hours later.

 

Activists for the sexual and reproductive rights of women in El Salvador demonstrate on Mar. 22 outside the Inter-American Court of Human Rights in San José, Costa Rica, during the hearing for the emblematic case of Beatriz v. El Salvador. Many carried green balloons, whose color is a symbol of the fight for the right to abortion in Latin America. CREDIT: Collaborating Organizations

 

Misogyny on the part of the State

Since 1998 El Salvador, this Central American country of 6.7 million inhabitants, has been the most drastic in the region in the persecution of abortion, punishing women who terminate their pregnancies with sentences of up to 30 years, in all cases, even when the life and health of the pregnant woman is at risk or in cases of rape.

The legislation mainly affects poor women in rural areas. According to data from women’s rights organizations, 181 such cases have been prosecuted since 2019.

Guillermo Ortiz, a gynecologist and obstetrician who specializes in high-risk pregnancies, testified before the Inter-American Court: “Yes, I saw many women die because they did not have access to a safe abortion, despite my having requested it.”

In her testimony, Beatriz’s mother said that the many doctors who treated her daughter had recommended that the pregnancy be terminated, but did not dare to perform an abortion or c-section to remove the fetus, for fear of going to prison.

“They told my daughter that they couldn’t, because in El Salvador it’s a crime, and if they did, they could go to jail,” said the mother.

“The State failed Beatriz twice,” said the mother, before breaking down in tears.

She was referring to the failure to carry out an abortion promptly, despite her daughter’s serious health conditions. She also was talking about a motorcycle accident that the 22-year-old suffered later.

“She had an accident that shouldn’t have been fatal, she was in stable condition” when she was admitted to the hospital in Jiquilisco, a municipality in the eastern department of Usulután.

But a storm caused a flood in some parts of the hospital, so they transferred her to the hospital in Usulután, the capital of the department.

“The doctor who treated her there didn’t even know what lupus was,” she said. In the hospital, Beatriz caught pneumonia.

The mother’s testimony and that of the other witnesses at the hearing has been closely followed in El Salvador and other nations by feminist and human rights organizations that have been monitoring and criticizing the country’s strict anti-abortion law.

Pinar Selek, a Turkish writer, is the victim of one of the most Kafkaesque trials in Turkey's history. Credit: Juantxo Egaña/IPS

By Karlos Zurutuza
BIARRITZ, France, Mar 23 2023 (IPS)

The woman we’re meeting in a house on the outskirts of Biarritz -800 kilometres southwest of Paris- is a university professor, the author of several books and hundreds of articles, and a well-known human rights activist.

Several human rights watchdogs have consistently denounced Selek's case. Human Rights Watch describes it as “the perversion of a criminal justice system”; the International PEN Club - a world association of writers with consultative status at the UN- includes Selek in its list of 115 authors who suffer harassment, arrest or violence around the world

According to Turkish courts, she also planted a bomb that killed seven people and injured more than 120 in Istanbul’s Spice Bazaar 25 years ago.

“Up to four scientific reports, including the one from the Turkish police themselves, pointed to a gas explosion, but later they said that it had been a bomb, and that I had planted it,” Pinar Selek tells IPS. This 51-year-old Turkish woman is embroiled in one of the strangest trials in the history of the Turkish judiciary.

“It’s Kafkaesque,” she blurts. “The case is based on the testimony of a Kurdish man who said that we had planted the bomb together. Later, he claimed to have confessed under torture, and that he didn’t even know me. He is free in Turkey, and I am in exile.”

On June 21, 2022, the Turkish public news agency Anadolu announced the annulment by the Supreme Court of Turkey of Pinar Selek’s fourth acquittal. Previously, she had been found innocent in three criminal proceedings.

But the sentence to life imprisonment is already firm and unappealable. On January 6, 2023, the Istanbul Court of First Instance issued an international arrest warrant for her.

Martin Pradel, Selek’s lawyer, talks about a “purely political case”.

“I have never heard of any other case that has gone on for 25 years without legal evidence of any kind. And this is without mentioning that Pinar has been acquitted up to four times,” Pradel told IPS over the phone from Paris.

The lawyer urged the French state to give Selek protection as a French citizen. If not, he added, the next step would be to appeal to the European Court of Human Rights.

 

Several French town halls such as the one in Marseille have also turned to her case. On March 29 she will receive the Medaille de la Ville de Paris, a recognition awarded by France´s capital city (Courtesy Pinar Selek)

 

“Where are they?”

Born into an Istanbul family of left militants, Pinar Selek has devoted her life to making visible those “invisible” in her country of origin: women and Kurds, prostitutes, Roma, homosexuals, Armenians…

“Where are they?” has always been her question as a researcher, and also as an activist. It was this vital commitment that brought her to prison in 1998, after refusing to hand the police a list of Kurdish contacts for one of her sociological studies.

“When they started building new prisons, we resisted being transferred. More than 300 died under attacks in which prisons were even bombed,” remembers Selek.

She was released after more than two years of captivity, torture, and a hunger strike in which, she says, dozens died. Back on the street, she was one of the founders of Amargi, a groundbreaking feminist organization in Turkey, and also the first feminist bookstore in the history of her country.

She has added a set of tales and a few books of her own to its shelves, but she has not been back in a long time. She had to leave the country in 2009 and, after getting her French citizenship in 2017, she settled down in Nice, where she teaches at the University Côte d’Azur, a public institution.

Ilya Topper, a Spanish journalist and analyst based in Istanbul for more than ten years, sees the trial opened against Selek in 1998 as “part of that brutal campaign against everything that seemed to treat Kurdish demands as a topic that could be discussed.“

“Until around 2005, anyone within a hundred meters of a protest which held a banner with a slogan that had any remote resemblance to a phrase once said by someone from the PKK (Kurdistan Workers’ Party) would be put in jail for many years,” the expert told IPS over the phone from Istanbul.

Until just over a decade ago, he adds, mayors were still sentenced for saying something in Kurdish on charges of “speaking a non-existent language.” He illustrates it with a concrete case:

“In 2011, a Kurdish mayor was sentenced to half a year in prison and a fine of 1,500 euros for naming a public park after Ehmedi Xani, an 18th-century Kurdish poet. The controversial issue was not the writer, but the initial letter of his last name: it is written with X, which exists in Kurdish, but not in Turkish.”

The trial against Selek, underlines the analyst, “highlights the deterioration of the Turkish Judiciary in a country where you can go to prison for any reason.”

 

Pinar Selek fears that her international arrest warrant will affect her family in Turkey and restrict her movement even within France. Credit: Juantxo Egaña/IPS

 

Solidarity

Several human rights watchdogs have consistently denounced Selek’s case. Human Rights Watch describes it as “the perversion of a criminal justice system”; the International PEN Club – a world association of writers with consultative status at the UN- includes Selek in its list of 115 authors who suffer harassment, arrest or violence around the world.

In a telephone conversation with IPS, its president, Burhan Sönmez, mentioned other notorious cases in Turkey, such as that of the publisher and human rights defender Osman Kavala, or the opposition politician Selahattin Demirtaş

“Both remain behind bars despite the European Court of Human Rights ruling for their immediate release,” Sönmez stressed from London.

Solidarity goes hand in hand with denunciation. More than a hundred personalities including intellectuals, political leaders and social agents will attend the hearing to be held in Istanbul on March 31. It’s a legal formality to notify Selek of her firm life sentence.

Michele Rubirola, former mayoress of Marseille and today the first deputy of the consistory, is the one chosen to represent the city. In a telephone conversation with IPS, Rubirola spoke of “someone who is a victim of injustice and oppression.”

“Selek ‘s academic struggles have turned into political struggles, and the relentlessness of the political and judicial power she is facing consolidates her as a true human rights activist,” added the delegate.

A judicial process that has lasted a quarter of a century is reaching a key moment just a few weeks before decisive elections in Turkey, a referendum on the more than two decades in the power for Turkey’s President, Recep Tayyip Erdoğan.

“My trial is one of the indicators of the evil rooted in Turkey: it reflects both the continuity of the authoritarian regime and the configurations of the repressive devices,” laments Selek.

She also confesses concern about how it may affect her family in Turkey, and herself in her host country.

“I am convicted of a massacre and my movement may be restricted internationally, and even within France. Moreover, Turkey is asking me for millions in compensation for the deaths and the destruction and there´s an international financial convention that could be executed in France,” she recalls.

Today, her only certainty is that she will try to move on with her life. Other than her work at the university, she also gives talks and organizes events and protests. Exile, she says, “may have uprooted me from my country, but not from the street.”

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An abandoned school in Pama, Burkina Faso. Credit: Norwegian Refugee Council (NRC)

By Marine Olivesi
OUAGADOUGOU, Burkina Faso, Mar 23 2023 (IPS)

Over a million children in Burkina Faso are currently affected by school closures with 6,134 academic institutions shut as of February 2023, an increase of over 40 per cent since the end of the last school year.

Nearly one out of four schools country-wide are now out of service due to rampant insecurity and violence, which has forced close to two million people into displacement.

On the eve of the high-level conference on Education in Emergencies, organised by the European Commission and the United Nations Children’s Fund in Brussels, the Norwegian Refugee Council together with the Education Cluster in Burkina Faso and the FONGIH, two umbrella entities representing 87 national and international organisations operating in the country, called for increased access to education for children left behind, whether they are internally displaced or live in enclaved areas.

“Only about a quarter of the children driven out-of-school have been given new classrooms. The majority are left without access to education, robbing them of their childhood and of their chance to become independent adults and citizens,” said Hassane Hamadou, NRC’s country director in Burkina Faso.

“The longer this situation drags on, the graver it becomes, the harder it will be to reverse this trend and protect their futures. The authorities in Burkina Faso as well as humanitarian and development organisations must urgently renew their efforts to stop this educational hemorrhage.”

Out of eight schools, only two are operational in the blockaded town of Pama in the East region, one of the three regions with the highest number of school closures along with Sahel and Boucle du Mouhoun. Six teachers and a few volunteers are currently serving over 1,000 children in Pama.

“For those of us who are still here, it’s a very personal decision to stay,” explained a teacher. “Education is a universal right, so we feel it’s our duty to carry on. But fear doesn’t go away easily. Often, we have to stop classes because we hear gunshots here or there.

Threats loom large, and conditions are tough, but we can and must overcome challenges to assist children who never wished to be put in this situation.”

Over 31,000 teachers have been affected by the education crisis nationwide, of which about 6,300 have been redeployed so far in schools hosting large numbers of internally displaced students. The reopening or relocation of around 300 schools since January marks a welcome step in the right direction.

However, it is now crucial to increase the use of “double shifts approach” in operating schools, to set-up more classrooms wherever possible, and to accelerate the reassignment of teachers to new sites in displacement areas.

This crisis has disproportionately impacted girls. A study conducted by Plan International revealed that girls are 2.5 times more at risk of being driven out of schools than boys in a crisis situation. Meanwhile, ongoing efforts to help teachers meet the growing psycho-social needs of students often traumatized by displacement and conflict must be sustained and increased nationwide.

“Insecurity is a big part of why so many schools close, but food insecurity in the Sahel and East regions is also a driver of school dropouts,” said Tin Tua’s director, Yembuani Yves Ouoba. “Guaranteeing that schools and non-formal education centers provide meals and children are being fed are effective ways of keeping them in the system.”

“We are witnessing an accelerating assault on education. Teachers are threatened and parents are frightened. Children are paying the heaviest price. When a child is not at school, he is more at risk of being exploited, being a victim of violence and trafficking, or even being recruited by armed groups,” said the Representative of UNICEF in Burkina Faso, Sandra Lattouf.

“We welcome the effective partnership and collaboration with the Ministry of National Education, Literacy, and Promotion of National Languages, which is strengthening access to education in challenging contexts. We must act now to not lose the next generation and renew efforts to strengthen emergency and alternative education solutions.”

Parties to the conflict must do more to protect school infrastructures from attacks and not occupy academic buildings. We welcome the upcoming inter-ministerial order to set up national and regional committees in charge of the implementation of the Safe School Declaration and hope they help make schools safe for all Burkinabè children.

• At the end of February 2023, 6,134 schools were closed in Burkina Faso, a 44% increase since May 2022 (4,258). This represents 24% of all academic structures in the country. (Source: Ministry of Education’s statistical monthly report on Education in Emergencies from February 28, 2023)
• Number of closed schools in other West and Central African countries due to insecurity: 3,285 in Cameroon, 1,762 in Mali , 1,344 in the Democratic Republic of Congo, 878 in Niger, 181 in Nigeria, 134 in Chad and 13 in Central African Republic (Source: Unprecedented School Closures Jeopardise the Future of Millions in West and Central Africa, NRC, UNHCR, UNICEF, Education Cannot Wait, March 2023).
• The regions of Boucle du Mouhoun, East and Sahel in Burkina Faso are the most impacted by school closures and each hosts between 1000 and 1200 closed schools. (Source: Ministry of Education’s statistical monthly report on Education in Emergencies from February 28, 2023)
• School closures impact 1,050,172 students as well as 31,077 teachers. 262,388 of these children have so far reintegrated a formal classroom. (Source: idem)
• Girls are 2,5 times more at risk of being driven out of school than boys in a crisis situation according to a 2020 study conducted in Mali and Burkina Faso (Adolescent girls in crisis, voices from the Sahel, Plan International, August 2020)
• Two schools out of eight are currently operational in Pama, with 6 teachers and 6 volunteers serving over 1,000 children. (Source: NRC interviews of teachers in Pama, March 2023)

Marine Olivesi, is Advocacy Manager for Norwegian Refugee Council in Burkina Faso

IPS UN Bureau

 

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Longtime political prisoners in Bhurtan, in photos provided by their families. Top row: Lok Bahadur Ghaley; Rinzin Wangdi; Chandra Raj Rai; Kumar Gautam. Bottom row: San Man Gurung; Birkha Bdr Chhetri; Omnath Adhikari; Chaturman Tamang. © Private.

By Elaine Pearson
SYDNEY, Mar 23 2023 (IPS)

“The physical torture was merciless,” said one man, “so we had no option but to present ourselves to the court based on [the security forces’] demands and their statements.”

“They would beat me up, so I confessed, although it wasn’t true,” said another.

Such allegations have appeared over and over  again in the work of Human Rights Watch around the world. But most people don’t expect to hear them from the Himalayan kingdom of Bhutan, whose rulers famously claim to maximize “gross national happiness” instead of mere GDP. This idea, enshrined in the kingdom’s 2008 constitution, has been taken up by economists and the United Nations, and inspired an annual World Happiness Report.

But Human Rights Watch has documented the presence of  at least 37 inmates in the country’s prisons who are described under Bhutanese law as “political prisoners” because of alleged political crimes against the state.

The origin of most of these cases goes back to the period around 1990, when the Bhutanese state drove around 90,000 Bhutanese who speak Nepali as a first language into exile. In a country that had around 550,000 people, that was a large share of the population

The origin of most of these cases goes back to the period around 1990, when the Bhutanese state drove around 90,000 Bhutanese who speak Nepali as a first language into exile. In a country that had around 550,000 people, that was a large share of the population.

The ruling elite, from the Ngalop community, had come to see the Nepali-speaking community as a threat to Bhutan’s cultural identity and their own dominant position. New, discriminatory citizenship laws stripped many of their citizenship, while “Bhutanization” laws aimed at enforcing a version of national identity based on Ngalop culture and language.

Amid widespread security force abuses, many Nepali-speakers were forced to flee and became refugees in nearby Nepal, although a sizable Nepali-speaking community remained in Bhutan.

Thousands were arrested for peacefully protesting these policies. Many were released on the condition that they leave the country, or after serving their terms. Bur the longest serving political prisoners have been in prison, serving sentences of life without the possibility of parole, since 1990.

They include eight  former Nepali-speaking soldiers of the Royal Bhutan Army who allegedly attended protest  at a secretive and remote jail used to imprison former officials accused of treachery.

Another 15 Nepali-speaking Bhutanese have been imprisoned since 2008 – 12 of them serving sentences of life without parole. These were young men who had fled Bhutan as children with their families, and came back to Bhutan as part of a campaign for the right to return by a banned group called the Bhutan Communist Party.

Most were captured shortly after their arrival, some with small arms and others with political pamphlets. At their trials for treason, the prosecution contended that because their families fled when they were infants, these young men had “abandoned the country and decided to be enem[ies] of Bhutan.”

Five of the political prisoners belong to a different community known as Sharchops (“Easterners”). Four men and a woman are imprisoned for alleged connections to another banned political party, the Druk National Congress, which campaigned for parliamentary democracy and human rights in the 1990s – before Bhutan adopted a democratic constitution.

In every case for which  Human Rights Watch obtained testimony, it was alleged that the prisoners were severely tortured at the time of their arrest and trial. “He was tortured by the army,” said the sister of a prisoner who was arrested in 2008 and sentenced to life. “They [the prisoners] were beaten and burned. When I met him, he was very sad, his eyes were full of tears.”

Under the Bhutanese legal system at the time, none of the accused had defense lawyers at their trials. In 2019 the United Nations Working Group on Arbitrary Detention interviewed some of these prisoners, noted that under Bhutanese law they have “no prospect” of being released alive unless they are granted an amnesty, and recommended that their convictions be reviewed.

A prisoner who met the Working Group told Human Rights Watch that guards had warned inmates not to tell the UN experts the truth about their treatment: “You have to live with us. They will leave tomorrow, so think wisely before speaking.”

The prisoners are prevented from making or receiving telephone calls to their families in Nepal, or other countries — such as the United States, Canada, or Australia — where refugees have resettled. They are also prevented from sending letters, and their families do not know whether the letters they send are delivered. This causes great distress to the prisoners themselves, and their loved ones, who don’t know what condition they are in.

Bhutan’s legal philosophy is guided by Buddhist principles emphasizing concepts such as “compassion.” The country is now a parliamentary democracy, but King Jigme Khesar Namgyel Wangchuck is still uniquely empowered to release these prisoners. It can be done. In 1999, his father King Jigme Singye Wangchuck granted amnesty to 40 political prisoners. Only last year, the king granted amnesty to a political prisoner serving a life term.

These cases belong to a different time, before Bhutan’s 2008 democratic reforms. Bhutan should  let all the political prisoners return to their families.

 

Excerpt:

Elaine Pearson is Asia director at Human Rights Watch

Governments low- and middle-income countries are encouraged to take note of a new story that finds cash transfers help with mental health of those living in poverty. Credit: Annie Spratt/Unsplash

By Francis Kokutse
ACCRA, Mar 23 2023 (IPS)

Poverty alleviation policies, especially cash transfers, will not only improve the poor condition of the beneficiaries but can also play a role in strengthening the psychological health of people as well as improve the mental health of those living in poverty in low- and middle-income countries (LMICS), including Africa, a new study has said.

An example of these poverty alleviation programmes is the Livelihood Empowerment Against Poverty (LEAP), under Ghana’s ministry of gender, children and social protection for extremely poor and vulnerable households. This is made up of orphaned children, persons with severe disabilities without productive capacity as well as elderly persons who are 65 and above.

The aim is to improve, among other things, basic household consumption, and nutrition among children below two years of age and the aged. It is also intended to increase access to health care services among children below five years of age.

The study found more than 20,000 Africans, out of 26,794 people receiving these cash transfers under poverty alleviation programmes in six countries across Africa, admitted that this financial assistance does have some effect on their mental health.

A co-author of the study, Clara Wollburg, affiliated with the department of social policy and intervention, University of Oxford, Oxford, told IPS, “13 out of the 17 studies were conducted in Sub-Saharan Africa. Of those studies, four were located in Malawi, four in Kenya, two in South Africa, and one each in Zambia, Mali, and Uganda.”

The World Health Organization defines mental health as “a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community.” And in Africa, StrongMinds Uganda says “despite the high prevalence of mental illnesses across the continent, mental health remains under prioritized in many African countries.”

The study, “Do cash transfers alleviate common mental disorders in low- and middle-income countries? A systematic review and meta-analysis,” published in PLOS One journal on February 22, 2023, said their “findings lend weight to the hypothesis that poverty alleviation can play a role in strengthening psychological health of people living in poverty in Low and Middle-Income Countries (LMICs.)”

It said their “analysis shows that providing populations living in poverty with cash transfers leads to improvements of depression and anxiety disorders. However, these benefits may not be sustained once the financial support ends,” the authors said.

Nigerian-born associate professor in psychiatry living in the US, Andrews O Newton, said the recent Central Bank of Nigeria (CBN) decision that has denied a lot of people access to cash could lead to depression. “Depression is the commonest form of mental illness. However, most people do not know because sufferers are not seen outside. The chronic stress caused by governmental policies makes it more severe, and one terrible consequence is suicide,” Newton said. The CBN has since been legally obliged to delay its deadlines to redesign the currency.

He said, “extreme poverty dehumanizes,” adding that such a situation is likely to lead to “feeling sad and empty, poor concentration, lack of drive and motivation, poor sleep as well as lack of energy.

The study focused on people living in poverty, who are recipients of cash transfers, and participants in inactive control groups, who received no transfers or were enrolled at a later stage, served as a comparison group. Active control groups receiving alternative interventions were not included, as this makes a causal inference about the effects of the transfers difficult.

They included conditional and unconditional cash transfer programmes (CTPs) targeted at households living in poverty in LMICs but did not apply an absolute low-income/poverty threshold, relying only on the relative threshold for grant eligibility applied by the organizations administering the transfers.

“Our findings have important implications for policymakers in Africa as they show that providing cash transfers to people living in poverty not only improves poverty indicators and school attendance, for example, but also meaningfully impacts depression and anxiety outcomes of beneficiaries. This is especially true for unconditional cash transfers,” Wollburg said.

She said they analyzed cash transfer programs that were specifically targeted to low-income and/or deprived households as indicated by, e.g., low monthly household expenditure and consumption, inability to meet basic needs, food insecurity, low educational attainment and high HIV risk.

Esenam Abra Drah, a mental health advocate in the Ghanaian capital, Accra, said, “from personal experience if you don’t have money, it can be frustrating.” Esenam understands this because she was diagnosed with bipolar disorder in August 2015 at the time she was studying Bachelor of Arts degree in French and Linguistics at the University of Ghana.

Currently serving as an executive member of Psychosocial Africa, a grassroots mental health support group set up by, and for people with lived experience of mental illness, Drah admitted as the study showed that her situation affected her schoolwork though she was able to graduate.

The study cautioned that policies aiming to address the poverty-mental health cycle should consider unconditional, longer-term support to populations living in poverty.

IPS UN Bureau Report

 

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Cyclone damage in Vanuatu. Credit: UNICEF/ReliefWeb

By Jotham Napat and Patricia Scotland
LONDON, Mar 23 2023 (IPS)

Human life is sacred and every individual deserves an equal chance in life. We have a common desire, we all want to lead a free, fulfilling existence, with dignity, where our basic needs are met, with opportunities to advance and equal treatment under the law. These are fundamental human rights, protected by international law, which we all have a shared responsibility to protect.

Out of the horrors and bloodshed of war, we created an international system for cooperation between nations under the United Nations, with our rights enshrined by the Universal Declaration on Human Rights.

Today, our rights are threatened not only by weapons, but by the destruction of our environment, our earth, our only home.

Climate change is wreaking havoc on people’s basic human rights to life, food, water, housing, health and a decent standard of living. And as the IPCC stated just this week, we have a “rapidly closing window of opportunity” to prevent this destruction.

Hon Jotham Napat

We cannot let these rights be taken away from us – particularly from vulnerable communities. We must act.

This month, when formidable twin cyclones Judy and Kevin slammed into the small island nation of Vanuatu within days of each other, they laid waste to homes, infrastructure and crops, severely impacting more than 80% of the population.

And like many other climate-vulnerable Pacific Island countries, whose territories are 99 per cent ocean, Vanuatu could see more than a metre rise in sea levels by the end of the century, placing entire coastal communities further in jeopardy.

Elsewhere in the world, drawn-out droughts in East Africa – the worst seen in 40 years – are killing millions of livestock and placing 17 million people at risk of starvation.

In South Asia, tropical cyclones are becoming ever more destructive, with the likes of Cyclone Amphan (2020) displacing nearly five million people across India and Bangladesh.

These worsening conditions are not freaks of nature, they are a predictable – and predicted – process of intensifying environmental damage caused by human activity. The world’s scientific community is unanimous and unequivocal that human influence has driven up average global temperature, causing unprecedented changes across the entire climate system.

Rt Hon Patricia Scotland

The burning of fossil fuels to supply skyrocketing energy needs and the release of harmful greenhouse gases continue to trigger harmful, irreversible consequences for the environment – and it is the most vulnerable which suffer the most.

It is one of the world’s deepest injustices and the root of growing inequality. While the most climate vulnerable countries have contributed the least greenhouse emissions that cause climate change, they are forced to endure the very worst of its impacts.

Small island developing states – two thirds of which are in the Commonwealth – contribute less than 1 percent of global emissions, while the world’s poorest nations contribute less than 4 percent. Yet it is their people who are frequently and directly in jeopardy, including their rights to development, self-determination and a healthy environment.

Addressing these injustices provides the foundation for an initiative led by Vanuatu, a Commonwealth member country, to obtain official advice from the world’s highest court.

On 29 March 2023, Vanuatu, along with more than 115 other co-sponsoring countries including a host of Commonwealth nations, will table a proposed resolution at the United Nations General Assembly requesting an advisory opinion on climate change from the International Court of Justice.

Such an opinion, though non-binding, would outline the obligations of states under international law to protect the environment and future generations from climate change. It would also clarify the legal consequences of harming the environment, taking into account the impacts on vulnerable communities and future generations.

This is not an attempt to blame or shame countries for the policies of the past, it is an attempt to clarify international climate obligations which can help all nations be more ambitious and effective. It has the potential to focus climate action not only on degrees of Celsius and tons of carbon, but on to preventing the most serious climate impacts on our people and our planet.

Disaster response efforts led by the National Disaster Management Office of Vanuatu to support affected communities after dual Cyclones Judy and Kevin. Credit: NDMO Vanuatu

This moment deserves our attention. All Commonwealth countries adhere to the Commonwealth Charter, which places the utmost importance on protecting the environment, and centralises the need for multilateral cooperation, sustained commitment and collective action on climate change. The International Court of Justice plays a vital role in multilateral cooperation as the main judicial organ of the United Nations – and the Commonwealth Charter emphasises the value of the rule of law at every turn.

There is no question that international law can be a vital tool in establishing and delivering climate justice. In the most vulnerable parts of the world, it is often all that stands between climate resilience and catastrophe, between prosperity and destitution.

When the resolution is tabled at the General Assembly, it will be worthy of careful consideration and support by all UN Member States. The breadth and diversity of countries at the heart of this effort underscores the grim reality that climate change does not, and will not, spare any of us. In this, we do not have a choice, only a responsibility, because it is a matter of life or death. We must therefore use every mechanism at our disposal to rise to the challenge of climate justice in a fair and effective way.

Hon Jotham Napat is the Minister of Foreign Affairs, International Cooperation and External Trade of Vanuatu, a Pacific Island nation on the frontlines of climate change.

Rt Hon Patricia Scotland, KC is the sixth Secretary-General of the Commonwealth, and the first woman to hold the post. She leads an organisation of 56 countries working together to promote democracy, peace and sustainable development.

IPS UN Bureau

 

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Black Sea Grain Initiative has been renewed - for now. Credit: Ihor Oinua/Unsplash

By Alexander Kozul-Wright
GENEVA, Mar 22 2023 (IPS)

Given the complex interplay between geopolitics and financial markets, Russia’s invasion of Ukraine in February 2022 sent shockwaves across the global economy. Admittedly, the implications both within and between countries have varied. However, there were some common denominators, including higher commodity prices.

Price disruptions were particularly severe for ‘soft’ agricultural commodities. During peacetime, Russia and Ukraine produced a large amount of the world’s grain, supplying 28 percent of globally traded wheat and 75 percent of sunflower products. Before the war, they were also among the world’s top providers of barley and corn.

After the start of hostilities, exports of grain were severely disrupted. For four months, Russian military vessels blocked Ukrainian ports. Supply constraints triggered market volatility and price rises. Wheat, for instance, reached a record high in March 2022. This left millions of people, particularly in developing countries, at the frontline of a food crisis.

Then, in July 2022, two agreements were signed: one was a memorandum of understanding between the UN and Moscow to facilitate global access for Russia’s food and fertilizer exports; the second was the Black Sea Grain Initiative (BSGI), signed by Russia and Ukraine, facilitating the safe export of grain and other foodstuffs from Ukrainian ports via the Black Sea.

Brokered by the UN and Turkey, the BSGI opened a protected maritime corridor through Ukraine. The agreement assuaged concerns about global grain supplies and led to price declines. Over 900 ships of grain and other foodstuffs have left Ukraine’s major ports since last summer.

Prior to the conflict, between 5-6 million tons of grain were exported from Ukraine’s seaports every month, according to the International Grains Council. By the end-2022, Ukraine had once again reached its historical exporting capacity (at just under 5 million tons). Production responses elsewhere also helped to increase global supplies.

Still, Ukrainian exports to developing countries remain below pre-war levels. And while unblocking the trade corridor did help to address food insecurity in 2022, export backlogs were significant. Today, grain prices (while they have come down in recent months) remain elevated.

Against this backdrop, negotiations between UN officials and Russian Federation representatives – headed by Deputy Foreign Minister Sergei Vershinin – kicked off in Geneva last Monday on a possible extension of the BSGI. Subsequent to a four-month renewal last year, the deal was set to expire on March 18th.

Earlier this month, UN Secretary-General Antonio Guterres highlighted the deal’s importance. He stressed that “it contributed to lowering global food costs and offered critical relief to people…, particularly in low-income countries.” Ukraine’s president, Volodymyr Zelensky, also called for the initiative to be extended.

For their part, Russian officials argued that ‘hidden’ sanctions – targeting fertilizer firms and the country’s main agricultural bank – have undermined commodity exports. By way of background, exemptions were carved out for some Russian food and fertilizer products after Western sanctions first targeted the Kremlin in February 2022.

In Geneva, delegates stressed that over-compliance and market avoidance by private companies had resulted in Russian commodity exports being under-traded. They noted that sanctions on its payments, logistics, and insurance systems created a barrier for Moscow to sell its grains and fertilisers in international markets.

In response, they requested that national jurisdictions enhance exemption clarifications for food and fertilizers products. “I think it’s a fair request,” says Jayati Ghosh, professor of economics at the University of Massachusetts, Amherst. “Hidden sanctions are impeding Russian financial transactions and undermining allegedly exempted exports.”

When the BSGI was last renewed in November, Russia threatened to renege on the deal unless hidden sanctions were addressed. While they eventually agreed to an extension, Moscow has since insisted that its own agricultural exports (notably ammonia) be included in the BSGI as a condition for its renewal.

Under the deal’s latest iteration, Russia’s pre-condition went notably unaddressed. Moscow, in turn, agreed to extend the deal for just two months. Ukraine, meanwhile, issued conflicting statements on the matter. Over the weekend, Deputy Prime Minister Oleksandr Kubrakov tweeted that the agreement had been extended for four months.

So far, the UN has not specified the length of the renewal, but “this could be the last time an extension is agreed,” according to Ghosh. “Russia is probably going to use this latest agreement as a threat. Rejecting a third extension in the spring may force the international community to listen to their concerns”.

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A woman with tuberculosis in Pakistan went undiagnosed for five years because she could not afford the $2 transportation cost from her village to the Civil Hospital in Tharparkar. Credit: OCHA/Zinnia Bukhari
 
Each year, the UN commemorates World TB Day—March 24-- to raise public awareness about the devastating health, social and economic consequences of tuberculosis (TB) and to step up efforts to end the global TB epidemic. The date marks the day in 1882 when Dr. Robert Koch announced that he had discovered the bacterium that causes TB, which opened the way towards diagnosing and curing this disease.

By Nyuma Mbewe and Swati Krishna
LUSAKA / PUNE, Mar 22 2023 (IPS)

Despite being both curable and preventable, the TB pandemic is a global health crisis and a leading cause of death worldwide. COVID-19 brought into sharp focus how women bear the brunt of pandemics. In 2021, over three million women and girls fell ill with TB, resulting in 450,000 needless deaths.

As women leaders in global health, on this 2023 World TB Day, we believe that systematic and sustained investment to tackle gender-related barriers is essential to get the world back on course and end TB by 2030.

We must confront the root causes of gender inequality and reshape the power dynamics across health systems, promoting the voice of women in their own care, to reach our global goals, for a safer, healthier world for all.

To better understand how gender norms and inequalities increase the burden, stigma and discrimination on women resulting in the failure to prevent, detect and treat TB infection, adopting an intersectional lens is a necessary step.

Differentiating the impact of TB based on the intersection of different determinants such as sex, gender, ethnicity, age, location and socioeconomic status can improve health planning, along with confronting legal, cultural and social barriers that are preventing improved health outcomes.

Using evidence-based knowledge, we can tailor interventions and care strategies for populations with increased vulnerabilities and curb the spread of the disease.

The Global Fund data has shown that women often face additional barriers to accessing TB diagnosis and treatment in countries with high rates of TB. Women generally wait longer than men for diagnosis and treatment, and may be discouraged from seeking care by a lack of privacy or child-care facilities in health services.

In some contexts, women have been less likely to undergo sputum smear examinations due to cultural norms and perceptions about femininity as well as gender dynamics of service provision. Young women in high HIV burden settings face increased TB risk.

The stigma, discrimination and exclusion associated with HIV amplifies and is amplified by TB-related stigma, especially for key populations. This impacts TB detection, access to reliable health services and treatment adherence.

It is past time to prioritize measures that emphasize women’s fundamental role in building resilient health systems and workforce. Globally, women are 90% of frontline health workers, and 70% of the overall health workforce.

Despite challenging working conditions, and lack of formal representation, women continue to show outstanding leadership across the health sector. Evidence shows that community-based and ambulatory care results in better TB outcomes compared to hospital-based or inpatient care. Yet their contribution is often undervalued, underpaid, and they occupy less than one quarter of management roles.

Women are the vast majority of nurses and community health workers (CHW) that play a vital role in the delivery of TB care and people-centered approaches to treatment, yet their voices are more often than not absent from decision-making fora. Valuing women, working at all levels of health, including CHWs is essential for the prevention, detection and treatment success of TB.

Making health systems fit for purpose means promoting gender parity in management, leadership, and governance. Mechanisms that harness the talent and expertise of women in the health workforce will result in better health systems, and support improved health governance.

Women in Global Health is committed to work with global health institutions to ensure that structural gender barriers are addressed and promote accountability for resilient health systems that improve health at every level.

Recent history has taught us that pandemic responses have often overlooked the specific needs of diverse women. Health leaders must promote and create opportunities for gender transformative leadership to strengthen health systems and ensure quality services. It is urgent to both recognize and include women and people of all gender identities for more impactful health interventions.

As we commemorate World TB Day, we appeal for increased efforts and stronger commitments to promote gender parity in decision-making across the health sector. This must be matched with sustained investments in gender transformative policies and programs to build resilient health systems and a workforce that adequately represents the diverse communities it serves.

Dr Nyuma Mbewe, a member of the Women in Global Health, Zambia Chapter, is an Infectious Diseases Physician with Zambia’s National Public Health Institute and is based in Lusaka, Zambia.

Dr Swati Krishna, a member of the Women in Global Health, India Chapter, is Young Investigator at KEM Hospital Research Centre and consultant to the iDEFEAT TB project of the International Union Against Tuberculosis and Lung Disease. She is based in Pune, India.

IPS UN Bureau

 

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Using naturally occurring microbes, a Kenyan entrepreneur has developed a molasses-based supplement that pre-ferments animal feeds to unlock all the necessary nutrients that would otherwise find a way out of the animal through cow dung, and dairy farmers have fallen in love with the product. According to Henry Ambwere, the Nakuru-based entrepreneur who developed the […]

Small-scale growers are empty handed after forking out large sums for equipment and training.